NCG550225_Permit (Issuance)_20070727

A746,
NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Michael F. Easley, Governor William G. Ross,Jr.,Secretary
Coleen H.Sullins, Director
July 27,2007
Kenneth& Susan TuckerTucker
P.O. Box 525
Eden,NC 27288
Subject: Renewal of coverage/General Permit NCG550000
Moir Mill Road/Lot 3
Certificate of Coverage NCG550225
Rockingham County
Dear Permittee:
In accordance with your renewal application [received on January 23,2007],the Division is renewing
Certificate of Coverage(CoC)NCG550225 to discharge under NCG550000. This CoC is issued pursuant to the
requirements of North Carolina General Statue 143-215.1 and the Memorandum of Agreement between North
Carolina and the US Environmental Protection agency dated May 9, 1994 [or as subsequently amended].
If any parts,measurement frequencies or sampling requirements contained in this General Permit are
unacceptable to you,you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made,the certificate of coverage shall be final and binding.
Please take notice that this Certificate of Coverage is not transferable except after notice to the
Division. The Division may require modification or revocation and reissuance of the certificate of coverage.
Contact the Winston-Salem Regional Office prior to any sale or transfer of the permitted facility.
Regional Office staff will assist you in documenting the transfer of this CoC.
This permit does not affect the legal requirements to obtain other permits which may be required by
the Division of Water Quality or permits required by the Division of.Land Resources, Coastal Area
Management Act or any other Federal or Local governmental permit that may be required.
If you have any questions concerning the requirements of the General Permit,please contact Toya
Fields [919 733-5083,extension 551 or [e-mail]] or Susan Wilson [919 733-5083,extension 510
or [e-mail]].
Sincerely,
for Coleen H. Sullins
cc: Central Files
Winston-Salem Regional Office/Surface Water Protection
V,19.W123
1617 Mail Service Center,Raleigh,North Carolina 27699-1617 One
512 North Salisbury Street,Raleigh,North Carolina 27604 NorthCarolina
Phone: [phone]/FAX [phone]/Internet:www.ncwaterquality.org Naturally
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STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NCG550000
CERTIFICATE OF COVERAGE NCG550225
DISCHARGE OF DOMESTIC WASTEWATER FROM SINGLE FAMILY RESIDENCES AND
OTHER 100% DOMESTIC DISCHARGES WITH SIMILAR CHARACTERISTICS UNDER THE
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1,other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission,and
the Federal Water Pollution Control Act, as amended,
Kenneth & Susan TuckerTucker
is hereby authorized to discharge domestic wastewater [450 GPDI from a facility located at
Moir Mill Road/Lot 3
Eden
Rockingham County
to receiving waters designated as an unnamed tributary to Town Creek (Sharps Lake) in subbasin
03-02-03 of the Roanoke River Basin in accordance with the effluent limitations, monitoring
requirements, and other conditions set forth in Parts I, II, III and IV hereof.
This certificate of coverage shall become effective August 1, 2007.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 27, 2007.
for Coleen H. Sullins, Director
Division of Water Quality
By Authority of the Environmental Management Commission

, North Carolina Department of Environment and Natural Resources
Division of Water Quality
RENEWAL FORM FOR EXISTING PERMITTED FACILITIES
NPDES renewal application for continued coverage under General Permit NCG550000:
Certificate of Coverage NCG550225
(Please verify the information in items 1 &2 as correct, or note any corrections that should be made.)
(Please print or type all other answers)
1) Mailing address* of property owner:
Owner Name Susan Tucker/
2 2007
Street Address P.O. Box 525
Address Eden,NC 27288
Telephone (Home) 3 1., [v 2 - b 01 3 (Mobile)
(e-mail address)
*Address to which all permit correspondence will be mailed
2) Location of facility producing discharge*:
Facility ID Tucker Kenneth& Susan-Res
Address: NCSR 1945,
Eden,NC 27288 (Rockingham County)
Telephone (Home) _ (Mobile)
*If the facility is not yet constructed,give the street address or lot number where the structure will be
built.
3) Description of Discharge:
a) Type of facility producing waste (please check one):
Primary residence
❑ Vacation/second home
❑ Undeveloped property
O Other [describe]:
4) Please check the components that comprise the wastewater treatment system:
CIYSeptic tank ❑ Dosing tank CVPrimary sand filter C"Secondary sand filter
❑ Recirculating sand filter(s) Et/Chlorination ❑ Dechlorination
❑ Other form of disinfection: 0 Post Aeration(describe)
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